Length of the treatment and number of doses per day as major determinants of child adherence to acute treatment

Authors

  • H Chappuy,

    1. Service d’Urgences Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; Faculté et Université de Médecine Paris Descartes, Paris, France
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  • J-M Tréluyer,

    1. Pharmacologie Clinique and EA 3620, Hôpital Cochin Saint-Vincent-de-Paul Assistance Publique Hôpitaux de Paris Faculté et Université de Médecine Paris Descartes, Paris, France
    2. Unité de Recherche Clinique Paris Centre, Assistance Publique Hôpitaux de Paris, Faculté et Université de Médecine Paris Descartes, Paris, France
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  • S Faesch,

    1. Service d’Urgences Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; Faculté et Université de Médecine Paris Descartes, Paris, France
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  • C Giraud,

    1. Unité de Recherche Clinique Paris Centre, Assistance Publique Hôpitaux de Paris, Faculté et Université de Médecine Paris Descartes, Paris, France
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  • G Chéron

    1. Service d’Urgences Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; Faculté et Université de Médecine Paris Descartes, Paris, France
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Hélène Chappuy, MD, PhD, Service d’Urgences Pédiatriques, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France.
Tel: +331 44 49 43 70 |
Fax: +331 44 49 42 99 |
Email: helene.chappuy@nck.aphp.fr

Abstract

Objective:  To determine the rate of aftercare adherence to prescriptions from a paediatric emergency department and to identify predictors for nonadherence.

Methods:  Patients discharged from a French paediatric emergency department with at least one oral drug prescription were included. A telephone interview questionnaire was used to determine whether the child had received the treatments according to the prescription. Adherence was assessed according to three items: frequency of drug administration, length of treatment and drug administering method. Complete adherence was defined as adherence to the three items mentioned above, and nonadherent as nonadherent to at least one of the items. Influence of age, sex, pathology, language spoken at home, type of medical insurance, type of medication prescribed, diagnosis, dissatisfaction with the explanation of the medical problem, number of prescribed medications, length of the treatment and number of doses per day was assessed.

Results:  One hundred and five telephone interviews were exploited. The children were 60 boys (57%) and 45 girls (43%). The ages of these 105 children were between 0.2 and 12 years. The most common diagnoses were asthma and pulmonary infection. Complete adherence with the prescription was 36.2%. Three factors were significantly associated with nonadherence (p < 0.05): length of treatment, number of doses per day and male sex.

Conclusion:  This study suggests that simplifying treatment schedules is an effective strategy for improving compliance in paediatric emergency departments.

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